Letter to the editor
Alcohol misuse and the consumption of cigarettes and cannabis are associated with well-established impairments in physical and psychological health. Excessive consumption of these substances in Ireland now poses a major public health problem.

Per capita consumption of alcohol in Ireland increased by 41% between 1989 and 1999, the highest such increase among EU countries, leaving Ireland with the second highest alcohol consumption levels of all EU countries. Tobacco smoke remains the leading preventable cause of death and disability in Ireland. While statistics on cannabis use are less clear, a recent UN study found Ireland to have the highest levels of cannabis use in the 23 countries of Western Europe.